Doctor Name: | NICOLE MARIE GRANGER |
NPI Number: | 1003045832 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT, LMP |
License Number: | 15945 |
Business Practice Address: | 13712 Ne 20th Ave Vancouver, WA - 986862698 |
Business Phone Number: | 3605745944 |
Business Fax Number: | |
Mailing Address: | 9638 Sw Larson Rd, GASTON |
State: | OR |
Postal Code: | 971197721 |
Phone Number: | 5039980418 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 03/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 15945 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |